CHAPTER – V
The aim of the study was to assess the level of awareness on preconception care after marriage among unmarried college girls in selected educational institution at Salem. The study was Non experimental descriptive research design to assess the level of awareness regarding preconception care. Sample consists of 100 unmarried college students. The analysis and interpretation of the findings were presented in the chapter-1V.
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Objective-1: To develop & validate the informational booklet regarding preconception care after marriage for the samples based on the findings of the study.
In this study Informational booklet regarding preconception care after marriage prepared as a guide to improve the student’s knowledge on preconception care aspect. Booklet was prepared based on review of literature, textbook, published journals, internet search, published and unpublished thesis and personnel experience of the researcher. The content was organized into various sub topics such as General health measures which include the consumption of balanced diet, maintaining normal body weight & Components involved in preconception such as folic acid supplementation, stress reduction, mental preparation, understanding fertile period and early signs of pregnancy. It was validated by 5 experts.
Booklet was prepared before the assessment of the knowledge regarding preconception care. It was handed over to the samples after assessing the knowledge regarding preconception care. The responses of the samples after reading the Informational Booklet was assessed, which showed that out of 100 samples, all the samples have read the Informational Booklet. 89 samples really felt that the booklet was highly useful and remaining 11 felt even though it was used further teaching could have more benefitted them. The most useful section felt by the samples were consumption of balanced diet 45(45%), maintaining normal body weight 61(61%), folic acid supplementation 78(78%) and stress reduction 27(27%).
The finding of the study was supported by another study conducted by Vause, Jones, Evans, Wilkie, Leader., (2004) conducted a study whether counselling before conception is important. After completing the knowledge survey the woman was sent for initial assessment. 400 surveys were used for the data analysis. Patients were informed about the health optimization, consumption of folic acid, exposure to infectious disease, use of medication and use of recreational drug. Nulliparous women were found less knowledgeable. The more educated women had more knowledge. It was suggested that the women need their physicians to educate about pre-pregnancy lifestyle.
Objective-2:To assess the level of awareness regarding preconception care among samples.
In this study the baseline assessment of the present health status of the samples were assessed by collecting the history. Regarding the age of menarche majority of the samples 35% attained menarche in the age of 14 years, 25% at the age of 15 years, 24% at the age of 13 years, 12%at the age of 16 years, 3% at the age of 12years, and only 1% at the age of 17 years.
Regarding pattern of menstruation 73% were having regular menstruation and 27% were having irregular menstruation. With regard to discomfort before menstruation 43%were having discomfort before menstruation and 57% were not having discomfort. Regarding pain during menstruation 25% were having pain during menstruation and 75% were having no pain during menstruation.
About the Family history of consanguineous marriage majority of the students 33% parents had consanguineous marriage, 16% grandparents had consanguineous marriage, 8%sister had consanguineous marriage and only 3% brother got married consanguineously, 40% had no history of consanguineous marriage.
With regard to the Family history of high risk pregnancy majority of the samples 34% mother/sister had the history of vomiting, 6% had infertility, 4% had hypertension during pregnancy, 4%had Twin pregnancy and only 1% had the history of diabetes mellitus during pregnancy, 61% had no Family history of high risk pregnancy.
Regarding family health history majority of the samples 25% had the family health history of hypertension, 22% had diabetes mellitus, 8% had the breathing difficulty and only 4% had cardiac problem, 41% had no family health history.
Measurement data on Body Mass Index by checking height and weight & Hemoglobin was assessed with Saheli’s Hemoglobinometer. The Body Mass index was assessed which showed that 8% were having normal Body Mass index (18.5-24.9kg/m2), 37% were underweight (<18.5kg/m2) and 55% were overweight (25-29.9kg/m2).
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The hemoglobin was assessed using Sahelis Hemoglobinometer which showed that 25% were having normal Hemoglobin level (11-12mg/dl), 71% were moderate anemic (9-10mg/dl) and 4%were severe anemic (<8mg/dl).
This finding was supported by a study done by Raghe Reghunathan (2001) conducted a study on prevalence of anemia among pregnant women in rural backward colony in Kottayam District, Kerala. Hemoglobin estimation was done by using Sahelis hemoglobinometer. Researcher have found that 47.4% of women were moderately anemic, 26.3% were mildly anemic and 26.3% of women were severe anemic.
The level of awareness regarding preconception care after marriage was assessed by self administered knowledge questionnaire. The knowledge score showed that out of 100 samples 37% had inadequate knowledge, 61% had moderate knowledge and only 2% had adequate knowledge regarding preconception care. The mean score percentage was 49.3 which revealed inadequate knowledge. Booklet was giving to the samples to improve their knowledge.
The finding of this study was supported by a study conducted by Weerd, Van der Bij , Cikot, Braspenning, Braat., (2002) this study compares a self-administered questionnaires to history taking. 193 women from Netherlands were included in the study. A pre-conception health assessment of family history and two Family History surveys were completed by 186 couples at home. Agreement between the written and the oral answers was calculated using kappa statistic. The results showed that good agreement level was found for all sections of the preconceptional health assessment form (overall kappa = 0.88) except for the nutritional history (kappa = 0.70). The Family History surveys also showed a high agreement level (kappa = 0.92 for women and kappa = 0.90 for men).
The findings was also supported by another study conducted by Ezegwui HU, Dim C, Dim N, Ikeme AC., (2008) Study was to determine the awareness regarding preconception care. This is a cross-sectional study of women receiving antenatal care at Nigeria between October 2005 and March 2006. A total of 1,500 questionnaires were distributed while 1,331 were completed and returned giving a response rate of 88.7%. The mean age was 30.0 + 5.0 years. Of these, 573 (43.1%) women had heard of preconception care. The respondent’s awareness of preconception care and their ability to define the subject correctly increase significantly with their educational status and age. The majority believed that preconception care might improve the health of mother and child.
Objective-3: To find out the association between level of awareness regarding preconception care with their selected demographic variables-age, education, family monthly income, type of family, religion & area of residence.
In this study association was analyzed by using Chi-square between the level of knowledge regarding preconception care and selected demographic variables
The findings of the study showed that there was significant association between the level of knowledge and their area of residence. The other demographic variables (age, education, type of family, family monthly income and religion) were having no significance with the level of knowledge.
The statistical findings of association between level of knowledge and area of residence of the students was found to be statistically significant [Ï‡2 value=10.2016, Table value =.9.49 and df = 4 at 0.05 level] It evidences that there is significance between association of level of knowledge and area of residence of the students.
This finding of the study was supported by another study conducted by Chacko, Anding, Kozinetz, Grover, Smith., (2003) objective of the study was to assess knowledge of neural tube defect prevention by folic acid among adolescent and young adult women. Results of the study showed that of 387 women (mean age: 18 +/- 1.9 years), 72% were black and 28% were Hispanic. 44% answered that clinics were a major source of information of neural tube defect prevention, 52% had heard of folic acid, 45% had heard of neural tube defect, and 50% had heard of birth defects prevention by folic acid supplementation. Result showed that more Hispanic than black young women had heard of neural tube defect (59% vs39%). Pregnancy history, regular birth control use, and education level for age were independently associated with knowledge. In young women with low education level for age, regular birth control use was significantly associated with knowledge. Proper folate diet was not associated with the knowledge. The follow-up survey of the programme showed that 88% to 92% had the knowledge of neural tube defects and folic acid consumption.
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